While interviewing a client, the nurse records the assessment in the electronic health record. Which statement is most accurate regarding electronic documentation during an interview?
The client's comfort level is increased when the nurse breaks eye contact to type notes into the record.
Completing the electronic record during an interview is a legal obligation of the examining nurse.
The nurse has limited ability to observe nonverbal communication while entering the assessment electronically.
The interview process is enhanced with electronic documentation and allows the client to speak at a normal pace.
The Correct Answer is C
Choice A reason: This is an incorrect statement as it implies that breaking eye contact is beneficial for the client. In fact, breaking eye contact may reduce the client's trust and rapport with the nurse. The nurse should maintain eye contact as much as possible and use verbal and nonverbal cues to show active listening.
Choice B reason: This is an incorrect statement as it implies that electronic documentation is mandatory for all interviews. In fact, electronic documentation is not a legal obligation, but a preferred method of recording the assessment data. The nurse should follow the facility's policy and procedure for electronic documentation and ensure the accuracy, completeness, and confidentiality of the record.
Choice C reason: This is the correct statement as it acknowledges the challenge of electronic documentation during an interview. The nurse may miss some important nonverbal cues from the client, such as facial expressions, gestures, or posture, while typing on the computer. The nurse should balance the time spent on the computer and the time spent on the client and use open-ended questions and reflective statements to elicit more information.
Choice D reason: This is an incorrect statement as it implies that electronic documentation is beneficial for the interview process. In fact, electronic documentation may interfere with the flow and quality of the interview. The client may feel rushed or ignored by the nurse's attention to the computer. The nurse should pace the interview according to the client's needs and preferences and use electronic documentation as a tool, not a barrier.
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Correct Answer is B
Explanation
Choice A reason: Requesting a family member to remain with the client is not the best intervention to implement first. It may provide some emotional support, but it does not address the communication barrier. The family member may not be able to translate accurately or objectively, and may have their own biases or emotions.
Choice B reason: Obtaining a staff member who is a bilingual interpreter is the best intervention to implement first. It ensures effective communication and understanding between the nurse and the client. It also respects the client's cultural and linguistic preferences and needs.
Choice C reason: Using drawings that are universal for all cultures is not the most effective intervention to implement first. It may be helpful for some simple concepts, but it may not convey the full meaning or context of the assessment. It may also be misinterpreted or misunderstood by the client.
Choice D reason: Asking for the support of one of the client's friends is not the most appropriate intervention to implement first. It may violate the client's privacy and confidentiality, and may not ensure accurate or unbiased translation. The friend may not be familiar with the medical terminology or the client's condition.
Correct Answer is A
Explanation
Choice A reason: Smoking cessation is the most important lifestyle modification for the nurse to encourage. Smoking is a major risk factor for cardiac disease, as it increases blood pressure, heart rate, and oxygen demand, and damages the blood vessels and the heart muscle. Quitting smoking can reduce the risk of cardiac disease by 50% within one year.
Choice B reason: Regular exercise is a beneficial lifestyle modification for the nurse to encourage, but not the most important one. Exercise can improve cardiovascular fitness, lower blood pressure, and reduce body weight, but it does not eliminate the harmful effects of smoking on the heart and blood vessels.
Choice C reason: A low-fat diet is a helpful lifestyle modification for the nurse to encourage, but not the most important one. A low-fat diet can lower cholesterol levels and prevent atherosclerosis, but it does not reverse the damage caused by smoking to the heart and blood vessels.
Choice D reason: Stress reduction is a useful lifestyle modification for the nurse to encourage, but not the most important one. Stress can trigger the release of hormones that increase blood pressure, heart rate, and oxygen demand, and can also lead to unhealthy behaviors such as smoking, overeating, and alcohol abuse. However, stress reduction alone does not address the direct effects of smoking on the heart and blood vessels.
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